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ECT and etomidate-induced seizure-like activity

Published online by Cambridge University Press:  13 June 2014

MacDara McCauley
Affiliation:
Department of Psychiatry, Our Lady's Hospital, Navan, Co Meath, Ireland
Vincent Russell
Affiliation:
Cavan General Hospital, Co Cavan, Ireland

Abstract

Following the withdrawal of methohexitone from the market place psychiatrists and anaesthetists have been forced to seek out alternative anaesthetic agents for ECT. We report a case of etomidate-induced seizure-like activity. We review the literature on ECT and anaesthetic agents and discuss the alternatives available in accordance with a statement by The Royal College of Psychiatrists.

Type
Case reports
Copyright
Copyright © Cambridge University Press 2003

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References

1.Lebensohn, ZM. Electroconvulsive therapy: Psychiatry's hero or villain? Am J Social Psych 1984; 4(4): 3943.Google Scholar
2.Johnstone, EC, Deakin, JF, Lawler, Pet al.The Northwick Park electroconvulsive therapy trial. Lancet 1980; ii: 1317–20.CrossRefGoogle Scholar
3.Brandon, S, Cowley, P, McDonald, Cet al.Electroconvulsive therapy: results in depressive illness from the Leicestershire trial. BMJ 1984; 288: 22–5.CrossRefGoogle ScholarPubMed
4.Halliday, G, Johnson, G. Training to administer electroconvulsive therapy: A survey of attitudes and experience. Aust & NZ J Psych 1995; 29 (1): 133–38.CrossRefGoogle Scholar
5.Geddes, J. Evidenced-based medicine and psychiatry. Ir J Psych Med 1997; 14(3): 8384.CrossRefGoogle Scholar
6.Sackiem, HA, Decina, P, Prohovnik, I, Malitz, S. Seizure threshold in electroconvulsive therapy; effects of sex, age, electrode placement and number of treatments. Arch Gen Psych 1987; 44: 355–60.CrossRefGoogle Scholar
7.Freeman, CP ed. The ECT Handbook. The Second Report of the Royal College of Psychiatrists' Special Committee on ECT. London: Royal College of Psychiatrists, 1995.Google Scholar
8.Sackeim, HAet al.Effects of stimulus intensity and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. New Eng J Med 1993; 328: 839–46.CrossRefGoogle ScholarPubMed
9.Weiner, RD, Coffey, CE, Krystal, AD. The monitoring and management of electrically induced seizures. Psych Clinics N Am 1991; 14: 845–69.CrossRefGoogle ScholarPubMed
10.Weaver, LA Jr, Ives, J, Williams, R. The threshold number of pulses in bilateral and unilateral ECT. Bio Psych 1978; 13: 227–41.Google ScholarPubMed
11.Malitz, S, Sackiem, HA, Decina, Pet al.Low dosage ECT: electrode placement and acute physiological and cognitive effects. Am J Soc Psych 1984; 4: 4753.Google Scholar
12.Murugesan, G. Electrode placement, stimulus dosing and seizure monitoring during ECT. A NZ J Psych 1994; 28: 675–83.CrossRefGoogle ScholarPubMed
13.Sackeim, HA, Decina, P, Kanzler, Met al.Effects of electrode placement on the efficacy of titrated low-dosage ECT. Am J Psych 1987; 144: 1449–54.Google Scholar
14.Abrams, R. Electroconvulsive Therapy (2nd edn). Oxford: Oxford University Press. 1992.Google ScholarPubMed
15.American Psychiatric Association. The practice of electroconvulsive therapy: recommendations for treatment, training and privileges. Washington DC: American Psychiatric Association. 1990.Google Scholar
16.Freeman, C. Anaesthesia for electroconvulsive therapy. Statement from the Royal College of Psychiatrists Special Committee for the electroconvulsive therapy. Psych Bull 1999; 23: 740–41.CrossRefGoogle Scholar
17.Goroszeniuk, T, Albin, M, Jones, RM. Generalised grand mal seizure after recovery from uncomplicated fentanyl-etomidate anaesthesia. Anaesthesia and Analgesia 1986; 65: 979–81.CrossRefGoogle Scholar
18.Krieger, W, Koemer, M. Generalised grand mal seizure after recovery from uncomplicated fentanyl-etomidate anaesthesia. Anaesthesia and Analgesia 1987; 66: 284–85.CrossRefGoogle Scholar
19.Hansen, HC, Drenck, NF. Generalised seizure after etomidate anaesthesia. Anaesthesia 1988; 43: 805–6.CrossRefGoogle ScholarPubMed
20.Nicoll, K, Callender, J. Etomidate-induced convulsion prior to electroconvulsive therapy, [letter] Br J Psych 2000; 177: 373.CrossRefGoogle Scholar
21.Kugler, J, Doenicka, A, Laub, M. The EEG after etomidate. Anaesthesia Resuscitation 1988; 106: 3148.Google Scholar
22.Brookes, G, Barnes, R, Rigby, J. Implementing the Royal College of Psychiatrists' guidelines for the practice of electroconvulsive therapy. Psych Bull 2000; 24: 329–30CrossRefGoogle Scholar